COVID-19 (Coronavirus) Blog

The COVID Tracking Project

May 30, 2020 An excellent resource with the latest numbers on tests, confirmed cases, hospitalizations, and patient outcomes from every US state and territory. Also includes a racial data tracker and information about a COVID exit strategy. Brought to us by the volunteers at The Atlantic.

Click here to access The COVID Tracking Project

Study estimates 24 states still have uncontrolled coronavirus spread

May 23, 2020 The coronavirus may still be spreading at epidemic rates in 24 states, particularly in the South and Midwest, according to new research that highlights the risk of a second wave of infections in places that reopen too quickly or without sufficient precautions.

How a virus spreads (R naught).

Read the article from the Washington Post here.

Peer-reviewed data shows remdesivir for COVID-19 improves time to recovery

May 22, 2020 The randomized, controlled trial enrolled hospitalized adults with COVID-19 with evidence of lower respiratory tract involvement (generally moderate to severe disease). Investigators found that remdesivir was most beneficial for hospitalized patients with severe disease who required supplemental oxygen. Findings about benefits in other patient subgroups were less conclusive in this preliminary analysis.

Access the news release from NIAID here.

Coronavirus (COVID-19) Mortality Rate

May 21, 2020 Considering that a large number of cases are asymptomatic (or present with very mild symptoms) and that testing has not been performed on the entire population, only a fraction of the SARS-CoV-2 infected population is detected, confirmed through a laboratory test, and officially reported as a COVID-19 case. The number of actual cases is therefore estimated to be at several multiples above the number of reported cases. The number of deaths also tends to be underestimated, as some patients are not hospitalized and not tested.

Read the entire article from Worldometer here.

Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV): An Unprecedented Partnership for Unprecedented Times

May 18, 2020 It has been more than a century since the world has encountered a pandemic like coronavirus disease 2019 (COVID-19), and the rate of spread of COVID-19 around the globe and the associated morbidity and mortality have been staggering.1 To address what may be the greatest public health crisis of this generation, it is imperative that all sectors of society work together in unprecedented ways, with unprecedented speed. In this Viewpoint, we describe such a partnership.

Francis S. Collins, MD, PhD; Paul Stoffels, MD, JAMA Network. Read the full article here.

A Guide to Pandemic Scams, and What Not to Fall For

May 13, 2020 Fraudsters see opportunities to target us in these uncertain times. Here are their most popular schemes and how we can protect ourselves.

Lightning

Read the full article in the New York Times here.

They don’t struggle to breathe—but COVID-19 is starving them of oxygen

May 8, 2020 One alarming symptom robs many patients of blood oxygen well before they notice. Doctors are racing to understand it.

Asthma inhaler.

Read full article in National Geographic here.

A snapshot of coronavirus in the U.S.: A high plateau of new cases portends more spread.

May 7, 2020 For all the talk of a second wave of coronavirus cases hitting the United States this fall, one consideration is often lost: The country is still in the throes of the first wave of this pandemic.

A graph showing coronavirus daily cases on May 11, 2020

Read the full article in STAT here.

The race for coronavirus vaccines: a graphical guide: Eight ways in which scientists hope to provide immunity to SARS-CoV-2.

May 6, 2020 More than 90 vaccines are being developed against SARS-CoV-2 by research teams in companies and universities across the world. Researchers are trialling different technologies, some of which haven’t been used in a licensed vaccine before. At least six groups have already begun injecting formulations into volunteers in safety trials; others have started testing in animals. Nature’s graphical guide explains each vaccine design.

Read the full article in Nature here.

COVID-19: May 4, 2020 Updates on IHME COVID-19 predictions

May 5, 2020 Updated IHME COVID-19 Projections: Predicting the Next Phase of the Epidemic

Link to full article here.

How California nursing homes became coronavirus hot spots

May 4, 2020 At Canyon Springs Post-Acute in Santa Clara County, 69 patients and 30 staff had tested positive, and six residents are dead. "We weren't prepared," said a Redwood Springs nurse who has tested positive. "We lost control of the situation because we weren't talking about it." All three facilities share the same parent company: Plum Healthcare Group, a California entity that controls about 50 skilled nursing facilities in the state.

Woman staring out a window.

Read full article here.

A City Nurse: Healing in the I.C.U. During COVID-19

May 4, 2020 Meet Cady Chaplin, an intensive-care nurse at Lenox Hill Hospital. She just turned thirty. “Sometimes, after my shift, I walk in my apartment, slide down the door, and cry,” she says.

N95 respirator mask.

Read the full article in the New Yorker here.

The Covid-19 crisis too few are talking about: health care workers’ mental health

April 30, 2020 An excellent article from Jessica Gold, M.D., an assistant professor of psychiatry at Washington University in St. Louis about the stress healthcare workers are feeling working during the COVID-19 pandemic. As the pandemic has unfolded, healthcare workers or all stripes are dealing with an unprecedented crisis--one in which many say they feel betrayed by their employers, the healthcare system, and the government.

Sad man.

Read the full article here.

Caution Needed on the Use of Chloroquine and Hydroxychloroquine for COVID-19

April 24, 2020 The coronavirus disease 2019 (COVID-19) pandemic has propagated global shock waves that have disrupted nearly every aspect of human endeavor. Nowhere has this been more evident than in health care. Health care delivery systems in some locations have been overwhelmed, and even those not so severely affected have had to reorganize and restructure to concentrate resources to meet an anticipated surge of patients who are critically ill.

In the absence of rapid and reliable testing, proven therapies, or even standard protocols for treatment, physicians and other clinicians have been forced to improvise, in some cases relying on the thinnest of evidence, to treat patients who are desperately ill.

Lab worker testing for SARS virus.

Link to article: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765269

IHME Estimates for Easing Social Distancing

April 21, 2020 The Institute for Health Metrics and Evaluation has projected when states may be able to consider easing currently implemented social distancing policies – if and only if – strong containment measures already have been instituted.

Based on the latest available data and updated predictions of COVID-19 prevalence, the table below outlines potential timing of these considerations. Estimates suggest that 30 states may fall below the 1 prevalent case per 1,000,000 threshold during May (greens to the light yellow in the map below). This threshold is considered a conservative estimate of the number of COVID-19 infections that states could reasonably identify via active case detection and contact tracing.

Estimate for Relaxing Social Distancing

Link to full article: http://www.healthdata.org/covid/updates

COVID-19 Treatment Guidelines (NIH.gov)

April 21, 2020 These Treatment Guidelines have been developed to inform clinicians how to care for patients with COVID-19. Because clinical information about the optimal management of COVID-19 is evolving quickly, these Guidelines will be updated frequently as published data and other authoritative information becomes available.

A cell covered with COVID-19 virus particles. Colorized scanning electron micrograph of an apoptotic cell (green) infected with SARS-COV-2 virus particles (orange), isolated from a patient sample. Image captured at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. NIAID

Link to NIH COVID-19 Treatment Guidelines: https://covid19treatmentguidelines.nih.gov/introduction/

Sequence for Donning and Doffing Personal Protective Equipment (PPE)

April 18, 2020 Here's a nice graphic showing PPE for the COVID-19 pandemic. The link below this graphic shows the CDC-recommended sequence for donning and doffing PPE. 

COVID-19 PPE for Healthcare Personnel

Link to CDC donning and doffing guidelines: https://www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf

Antiviral remdesivir prevents disease progression in monkeys with COVID-19

April 17, 2020 Early treatment with the experimental antiviral drug remdesivir significantly reduced clinical disease and damage to the lungs of rhesus macaques infected with SARS-CoV-2, the coronavirus that causes COVID-19, according to National Institutes of Health scientists.

AN electron microscope image of the COVID virus shedding cells. This scanning electron microscope image shows SARS-CoV-2 (round gold objects) emerging from the surface of cells cultured in the lab. SARS-CoV-2, also known as 2019-nCoV, is the virus that causes COVID-19. The virus shown was isolated from a patient in the U.S.NIAID-RML Source: NIH

Link to full report: https://www.nih.gov/news-events/news-releases/antiviral-remdesivir-prevents-disease-progression-monkeys-covid-19

COVID-19 Compiler

April 11, 2020 A map showing the total number of coronavirus cases by county and state for the entire country.

Link to the map: https://covid19.topos.com/

Larry David, Master of His Quarantine, an interview with Maureen Dowd

April 8, 2020 When I ask if he is hoarding anything, he is outraged. “Not a hoarder,” he said. “In fact, in a few months, if I walk into someone’s house and stumble onto 50 rolls of toilet paper in a closet somewhere, I will end the friendship."

Maureen Dowd, New York Times, April 4, 2020

Link to the the entire interview:
https://www.nytimes.com/2020/04/04/style/larry-david-curb-your-enthusiasm-coronavirus-psa.html

Use of Cloth Face Coverings to Slow the Spread

April 4, 2020 CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

Link to CDC page on face covering: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

See Cases in Real Time--Johns Hopkins University

This website is tracking cases in real time using arcgis technology. Each time you access the site, the data is updated. Excellent resource being widely used by scientists and the media to keep us up-to-date on the coronavirus pandemic.

Johns Hopkins graph showing the increase in COVID 19 cases as of May 11, 2020.

Link to Johns Hopkins: www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Everyone Thinks They're Right About Masks

April 1, 2020 As the coronavirus pandemic continues, many people are now overthinking things they never used to think about at all. Can you go outside? What if you’re walking downwind of another person? What if you’re stuck waiting at a crosswalk and someone is there? What if you’re going for a run, and another runner is heading toward you, and the sidewalk is narrow? Suddenly, daily mundanities seem to demand strategy.

  A graphic showing the correct placement of a face mask.

Link to full article:
https://www.theatlantic.com/health/archive/2020/04/coronavirus-pandemic-airborne-go-outside-masks/609235/

Homemade personal protective equipment

March 30, 2020 The article contains specific instructions on how to construct a handmade mask, which was tested against an aerosol challenge with some measurable benefit.

Link to article on CIDRAP (Center for Infectious Disease Research and Policy).

Stephen Curry and Dr. Anthony Fauci | COVID-19 Q&A

March 26, 2020 Stephen Curry is joined by Dr. Anthony Fauci of National Institute of Allergy and Infectious Diseases to talk all about COVID-19.

Link to You Tube interview: https://www.youtube.com/watch?v=iuX826AGXWU

The Chain of Infection

March 25, 2020 The very nature of healthcare settings makes them vulnerable to the spread of infections because they serve patients who are ill and are therefore susceptible hosts. Patients with altered immunity such as people with cancer or HIV/AIDS are at high risk for infection. Surgical patients are at risk because any incision creates a new portal of entry for pathogens. Elderly patients may have weakened immunity simply because of their age. Healthcare workers are themselves at risk of infection because of their close daily contact with patients who may harbor pathogens. Thus, infection control (and breaking the chain of infection) is a primary component of safe, effective patient care.

The chain of infection.

We are offering this course at 50% off. Normally $10, we've cut the price to just $5.00. Take this opportunity to brush up on the chain: pathogen, susceptible host, portal of entry, mode of transmission, portal of exit, and reservoir. Go to Chain of Infection ►

CDC Guidance for Extended Use and Limited Reuse of N95 Masks

March 23, 2020 Supplies of N95 respirators can become depleted during an influenza pandemic or wide-spread outbreaks of other infectious respiratory illnesses. Existing CDC guidelines recommend a combination of approaches to conserve supplies while safeguarding health care workers in such circumstances. These existing guidelines recommend that health care institutions:

  • Minimize the number of individuals who need to use respiratory protection through the preferential use of engineering and administrative controls;
  • Use alternatives to N95 respirators (e.g., other classes of filtering facepiece respirators, elastomeric half-mask and full facepiece air purifying respirators, powered air purifying respirators) where feasible;
  • Implement practices allowing extended use and/or limited reuse of N95 respirators, when acceptable; and
  • Prioritize the use of N95 respirators for those personnel at the highest risk of contracting or experiencing complications of infection.

Link to full Guidance: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

Rampant Lies, Fake Cures and Not Enough Beds: What the Spanish Flu Debacle Can Teach Us About Coronavirus

March 17, 2020 Lasting just over a year, the 1918–1919 influenza pandemic stands as a lasting reminder of what happens when governments and their citizens fail to meet a crisis head on. From our perch today, as we brace for the coronavirus’ inevitable spread, the missteps of 1918 seem eerily prescient: A lack of leadership from Washington, with the gaps filled unevenly at the state and local levels.

Public officials who either lied, dissembled or made up facts. Hucksters who used popular media to misinform the public and make a quick buck in the process. Public health infrastructure that was inadequate to the challenge. And ordinary citizens who often refused to heed the warning of experts.

Joshua Zeitz
Politico magazine, March 17, 2020

Spanish flu death chart.

Link to full article:
https://www.politico.com/news/magazine/2020/03/17/spanish-flu-lessons-coronavirus-133888

Covid-19--Navigating the Uncharted

March 26, 2020 In this New England Journal of Medicine article, Anthony Fauci, Clifford Lane, and Robert Redfield discuss a study by Li and colleagues that provides a detailed clinical and epidemiologic description of the first 425 cases reported in the epicenter of the outbreak in the city of Wuhan in Hubei province, China. The article provides a case definition, case fatality rate, and discusses Covid-19's efficiency of transmission. 

Link to full article:
https://www.nejm.org/doi/full/10.1056/NEJMe2002387?query=RP

The Doctor Who Helped Defeat Smallpox Explains What's Coming
Epidemiologist Larry Brilliant, who warned of pandemic in 2006, says we can beat the novel coronavirus—but first, we need lots more testing.

March 19, 2020 In this fascinating interview in Wired magazine with Dr. Larry Brilliant, the epidemiologist talks about novel viruses, flattening the curve, the effectiveness of N95 masks, and the "gold ring"--an eventual vaccine and eventual herd immunity. Brilliant shares his experience and knowledge in a straightforward and engaging manner.

Link to full article: https://www.wired.com/story/coronavirus-interview-larry-brilliant-smallpox-epidemiologist/

Pandemic by Lynn Unger

March 23, 2020

What if you thought of it
as the Jews consider the Sabbath
the most sacred of times?
Cease from travel
Cease from buying and selling.
Give up, just for now,
on trying to make the world
different than it is.
Sing. Pray. Touch only those
to  whom you commit your life.
Center down.
And when your body has become still,
reach out with your heart.
Know  that we are connected
in ways that are terrifying and beautiful.
(You could hardly deny it now.)
Know that our lives
are in one another’s hands.
(Surely, that has become clear.)
Do  not reach out your hands.
Reach out your heart.
Reach out your words.
Reach out all the tendrils
of compassion that move, invisibly,
where we cannot touch.
Promise the world your love—
for better or worse,
in sickness and in health,
so long as we both shall live.

The Rev. Dr. Lynn Unger leads the Church of the Larger Fellowship, about which you can find more at their website, Quest for Meaning. She gave permission for ATrain Education to publish her poem “with all my best wishes to those who are on the front lines of this crisis.” March 23, 2020.